Table 8.
Detection of botulinum toxin in sera of patients with neuropathic symptoms mimicking botulism.
| Country | Year | Number of Patient’s Sera | Toxin Positive Sera | Additional Investigation | Symptoms | References |
|---|---|---|---|---|---|---|
| The Netherlands | 1988–1992 | 5 | 4 1 | GBS | [145] | |
| The Netherlands | 1994 | 6 | 1 1 | CSF protein: 125 mg/dL, electromyography | GBS | [144] |
| USA | 1998 | 1 | BoNT/B | CSF protein: 42 mg/dL, electrodiagnostic | possible concurrent botulism and MFS | [146] |
| Germany | 2004 | 1 | neg | strongly elevated IgG/IgM anti-GQ1b | MFS mimicking botulism | [159] |
| France | 2007–2009 | 38 | 24 1 | GBS/MFS | [47] and unpublished data | |
| USA | 2015 | 1 | BoNT/A | strongly elevated Ig anti-GQ1b CSF protein: 56 mg/dL negative detection of BoNT and C. botulinum in feces |
MFS | [147] |
| USA | 2017 | 1 | neg | strongly elevated IgG/IgM anti-GQ1b BoNT in recently ingested canned food |
possible concurrent MFS and food-borne botulism | [160] |
| Switzerland | 2017 | 1 | neg | elevated IgG anti-GM1, -GD1a, -GD1b | atypical GBS/MFS mimicking botulism | [136] |
1 Toxicity in sera not neutralized by specific anti-botulinum toxin type antibodies. GBS, Guillain Barré syndrome; MFS, Miller-Fisher syndrome; neg, negative.